In the ethics surrounding neuroscience, an initial question considered by the Presidential Commission for the Study of Bioethical Issues today was the definition of the words “self” and “person.”
The subject of neuroscience is one of three that the Commission is taking up this year. The other two are whole genome sequencing and effective countermeasures to protect children.
The discussion also delved into developments in neuroscience; the use of those tools; the rights of a person; and what happens in situations such as when a person suffers a brain injury or descends into dementia.
“We know when someone suffers a brain injury, or has Alzheimer’s Disease, we’re quick to say they have become a different person,” said James Wagner, the Commission Vice-Chair and the President of Emory University. “It may not be clear what we mean by that, or what we know about that, so in light of that we want to understand words like person and self.”
John Perry, Distinguished Professor of Philosophy at the University of California, Riverside, Emeritus Professor of Philosophy at Stanford, and co-host of “Philosophy Talk,” a radio program that “questions everything… except your intelligence,” said it was important to demystify the definition of self.
“It’s a fairly straightforward concept,” he said. “Self is just a way of talking about ourselves.”
He continued: “What we know about ourselves, or think about ourselves isn’t just limited to the special ways people have to know about themselves. For example, this morning, trying to figure out where I should come to the meeting, I looked at the Commission Website and … part of that was seeing my name. ‘Ah this is where I should be.’ You have a John Perry concept., and I have a John Perry concept that is different than from my self concept.”
Marya Schechtman, Professor of Philosophy at the University of Illinois at Chicago, and author of The Constitution of Selves, talked about the identity of a person revolving around their narrative.
A narrative, she said, is a story of how people view themselves. “Lives are full of happenstance and trivia as well as important events, and they are part of our narrative as well,” she said.
Dr. Bernard Lo, Professor of Medicine and Director of Program in Medical Ethics at University of California, San Francisco, turned the discussion toward “change in self” and what that meant in real-life situations faced by patients, families and doctors.
He told the story of his favorite aunt who developed dementia in old age. She had told him years earlier that if she faltered badly in her later years she did not want to be kept alive. He said when he visited her during her period of dementia, she remembered him and his son and “was smiling.” Then she contracted pneumonia. The question, he said, was whether her contentment should override her earlier conviction not to prolong her life if any complications developed.
“To put this in ethical terms, what do you do when priority directions contradict current best interests?” Lo said.
Anthony Wagner, Professor of Psychology and Neuroscience at Stanford University, described new advances in neuroscience. Some involved the use of functional MRI (fMRI). He said some initial conclusions from studies showed that fMRIs can detect whether someone is remembering an episode “with reasonable high accuracy.”
He also said that in some cases, fMRI tests in patients in “vegetative states” have shown detection of brain responses to questions.
Those developments, Commission members said, meant that it may be time to consider ethical questions around the use of neuroimaging before the technology progresses further.